Medisys Compliance

JULY 5, 2022

What is Medicare Overpayment? A Medicare overpayment exceeds regulation and statute properly payable amounts. When Medicare identifies an overpayment, the amount becomes a debt a healthcare provider owes the federal government. Based on this new information, CMS takes action to recover the mistaken Medicare payment.

Overpayments 52

Overpayments Overpayment Medicare Medicare 52

Medisys Compliance

JULY 13, 2023

Medicare recognizes the importance of diabetes self-management training and offers coverage for eligible beneficiaries. However, there are specific guidelines and conditions that need to be met for Medicare billing. Diabetes Education Billing Guidelines for Medicare Who May Furnish the Training?

Medicare 52

Medicare Medicare Medical Billing Outsourcing Health Outcomes 52

Medisys Compliance

APRIL 11, 2022

Billing for Ambulatory Surgery Centers (ASCs) is tightly regulated by numerous federal as well as state-level regulatory authorities. Complete documentation will support all procedure codes your billed and will provide complete picture for payers. Pre-operative medical record documentation. Discharge documentation.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Informed Consent Nurses 52

Medisys Compliance

MARCH 5, 2024

Understanding the Landscape of Cardiology Billing Cardiology billing encompasses a wide range of services, including diagnostic testing, interventional procedures, and ongoing patient care. Only complete or sufficient documentation can result in claim denials or downcoding.

Medical Billing Outsourcing 105

Medical Billing Outsourcing Medical Billing Compliance Governance 105

Medisys Compliance

JULY 29, 2022

We are sharing Medicare guidelines for laser-assisted cataract surgery billing from a last updated CMS document. We shared this document as it was published, to avoid any error while billing for laser-assisted cataract surgery. Medicare Policy Regarding Non-Covered Services.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

APRIL 10, 2024

Understanding Coverage and Coding Medicare reimbursement for HBOT hinges on the diagnosis. Optimizing Your Reimbursement Strategy Documentation is Key: When seeking reimbursement for HBOT, meticulous documentation is essential. Don’t let the complexities of HBOT billing hinder your ability to offer this vital treatment.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

FEBRUARY 27, 2024

Key regulations include the Health Insurance Portability and Accountability Act (HIPAA), the Stark Law, the Anti-Kickback Statute, and regulations set forth by the Centers for Medicare & Medicaid Services (CMS) and private payers. Documentation Requirements Accurate and thorough documentation is essential for radiology billing compliance.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

JULY 17, 2024

The revised codes now emphasize the duration and specificity of the infusion, requiring detailed documentation of the time and type of drugs administered. This change aims to simplify billing and reduce the chances of claim denials. Documentation Requirements Detailed documentation is now more critical than ever.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicare 59

Medisys Compliance

JUNE 30, 2022

Medicare Coverage for MNT. The Social Security Act authorizes Medicare Part B coverage of Medical Nutrition Therapy services (MNT) for certain beneficiaries who have diabetes or a renal disease. Medisys Data Solutions is a leading medical billing company providing complete assistance in medical billing and coding.

Medicare 52

Medicare Medicare Medical Billing Medical Billing Outsourcing 52

Medisys Compliance

JUNE 10, 2022

Medicare covers limited chiropractic services when performed by a chiropractor who is licensed or legally authorized to furnish chiropractic services by the State or jurisdiction in which the services are furnished. In this article, we shared coding guidelines and Medicare coverage for Chiropractic Manipulative Treatment (CMT).

Medicare 59

Medicare Medicare Medical Billing Medical Billing Outsourcing 59

Medisys Compliance

APRIL 25, 2024

Introduction The ever-evolving world of healthcare billing can feel complex, and with the introduction of MACRA (Medicare Access and CHIP Reauthorization Act) in 2015, cardiology practices have faced some adjustments. MACRA replaced the previously used Sustainable Growth Rate (SGR) formula for Medicare physician payments.

Medical Billing Outsourcing 64

Medical Billing Outsourcing Medical Billing Medicare Medicare 64

Medisys Compliance

JULY 31, 2024

Documentation Requirements Detailed documentation is crucial for supporting the medical necessity of immunotherapy. Comprehensive documentation ensures transparency and supports claims during audits. Key considerations include: Medicare: Medicare has established specific coverage criteria for various immunotherapies.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

MAY 23, 2024

Introduction The Centers for Medicare & Medicaid Services (CMS) establish specific billing guidelines for behavioral health services provided to Medicare beneficiaries. This article provides a comprehensive overview of essential information for providers navigating CMS behavioral health billing guidelines.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medical Billing Services Medicare 59

Medisys Compliance

JANUARY 21, 2024

Understanding the Bill and its Implications The mental health omnibus bill encompasses a multitude of provisions aimed at bolstering mental health resources and services. Mental Health Billing and the Mental Health Omnibus Bill These changes will undoubtedly affect billing practices.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicare Medicare 59

Medisys Compliance

FEBRUARY 7, 2022

Medicare pays a physician for an Annual Wellness Visit (AWV) service. This visit is planned to develop or update a Personalized Prevention Plan (PPP) and perform a Health Risk Assessment (HRA) which is covered once every 12 months by Medicare. Medicare also waives the AWV coinsurance or co-payment and the Medicare Part B deductible.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

JANUARY 11, 2024

Audits: Increased scrutiny from Medicare and Medicaid for potential coding discrepancies. Documentation Burden Detailed documentation is crucial for supporting claims and ensuring compliance with regulations. Proper medical terminology and abbreviations. Efficient documentation practices and record-keeping systems.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

AUGUST 27, 2024

This guide provides a detailed, technical overview of the key aspects involved in CPT coding for PT, helping you optimize your practice’s billing processes. Overview of CPT Codes in Physical Therapy CPT codes are used to describe medical, surgical, and diagnostic services.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Compliance 59

Medisys Compliance

NOVEMBER 21, 2023

Accurate and timely billing is a fundamental aspect of financial success for Skilled Nursing Facilities (SNFs), particularly when it comes to optimizing SNF billing. In this guide, we will explore into essential SNF billing tips to help you optimize your billing processes and navigate the complexities of reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Medical Billing 59

Medisys Compliance

AUGUST 23, 2024

The compliance process involves understanding and following payer-specific guidelines, particularly those set by Medicare. Example: Medicare’s guidelines for oncology coding are detailed and specific. Example: Medicare guidelines often change, particularly regarding how certain treatments like radiation therapy should be coded.

Compliance 59

Compliance Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

FEBRUARY 19, 2024

Diagnosis Drives Reimbursement: Accurately document diagnoses using ICD-10 codes that align with the group’s focus and individual client needs. Ensure diagnoses support the medical necessity of group therapy for each participant. If you treat Medicare or Medicaid patients, ensure you have the necessary knowledge and resources.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medicaid Medicaid 59

Medisys Compliance

APRIL 30, 2024

This article provides a comprehensive guide for anesthesiologists and providers on telehealth anesthesia billing, covering key aspects of telehealth billing. Eligible Services for Telehealth Billing The Centers for Medicare & Medicaid Services (CMS) maintains a list of services eligible for telehealth billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medicare Medicare Informed Consent 59

Medisys Compliance

JULY 16, 2024

Documentation Requirements Proper documentation is essential for justifying the services provided. Recent Changes in Mental Health Billing The landscape of mental health billing is continuously evolving. Medicare Updates Medicare has expanded its coverage for mental health services, including telehealth.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 5, 2024

Some common modifiers used in MPI billing include: 59 (Distinct procedural service): Used if a separate and medically necessary service is performed on the same day as the MPI (e.g., Medicare Coverage and Reimbursement MPI is covered by Medicare under specific conditions.

Medical Billing 64

Medical Billing Medical Billing Outsourcing Medicare Medicare 64

Medisys Compliance

JANUARY 20, 2022

The Centers for Medicare & Medicaid Services (CMS) recognizes that CCM services are critical components of primary care that promote better health and reduce overall health care costs. Billing Guidelines for Medicare Chronic Care Management. practitioner must obtain patient consent before furnishing or billing CCM.

Medicare 52

Medicare Medicare Medical Billing Outsourcing Medical Billing 52

Medisys Compliance

FEBRUARY 29, 2024

This article explores into the key considerations for optimizing billing for virtual care in primary care, ensuring you receive proper reimbursement for your services. Understanding Virtual Care Billing Codes Familiarizing yourself with the specific billing codes assigned by Medicare and private payers is paramount.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Informed Consent Medical Billing Medicare 59

Medisys Compliance

MARCH 15, 2024

For proper reimbursement, ensure your medical records clearly document the specific hormone or substance measured in the RIA test. Also document the medical reason for ordering the RIA test, linking it to the patient’s diagnosis and treatment plan. Stay updated on coding changes: CPT codes are periodically revised.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

APRIL 23, 2024

Implement Regular Audits: Regularly audit your billing processes to identify and address any coding inconsistencies or documentation gaps. missing information, coding errors) and have a clear process for appealing denials with proper documentation. This fosters trust and reduces billing surprises.

Medical Billing 59

Medical Billing Medical Billing Outsourcing Medicare Medicare 59

Medisys Compliance

FEBRUARY 21, 2024

Billing Components of CPT Code 59400 Antepartum Care: Antepartum care includes all prenatal visits and services provided to the pregnant patient before delivery. Each antepartum visit should be documented thoroughly, including the history, physical examination, medical decision-making, and any procedures or interventions performed.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Medisys Compliance

SEPTEMBER 29, 2022

This is exactly wherein the professional optometry billing companies step into the picture to toss away complex and stressful tasks. When it comes to denial management for optometrists, these physicians face scores of challenges, some of them are as follows: Bad or missing documentation. Failure to have a proper financial policy.

Medical Billing Outsourcing 98

Medical Billing Outsourcing Medical Billing Medicare Medicare 98

Medisys Compliance

AUGUST 30, 2024

Key CPT and ICD-10 Codes for Pain Management Accurate coding is the foundation of successful anesthesiology billing for pain management. It ensures that services are correctly documented, billed, and reimbursed. Medical Necessity: Establishing medical necessity is critical for securing reimbursement.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Medisys Compliance

AUGUST 21, 2024

In 2024, the Centers for Medicare & Medicaid Services (CMS) introduced several crucial updates to radiation oncology billing guidelines. These guidelines cover various aspects of billing, including CPT codes, HCPCS codes, ICD-10 codes, and documentation requirements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medicaid Medicaid 59

Medisys Compliance

APRIL 1, 2024

Documentation Requirements: Maintain thorough documentation of the telehealth encounter, including the communication method (video, audio-only, etc.), Patient Consent: Ensure patients have consented to receiving telehealth services and understand potential billing implications. Stay updated on your state’s regulations.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing COVID-19 Medicaid 59

Medisys Compliance

MAY 17, 2024

Medical Necessity: Payers may deny claims if they deem the service not medically necessary. This often involves providing clear documentation justifying the treatment plan. Missing or Incomplete Information: Claims with missing documentation or unclear notes may be denied for further review.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Medical Billing Services Medicaid 59

Medisys Compliance

JULY 9, 2024

Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Angina pectoris with documented spasm I21.01: ST elevation (STEMI) myocardial infarction involving the left main coronary artery I21.4: Use detailed clinical documentation and coding resources.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Compliance Medicaid 59

Medisys Compliance

AUGUST 1, 2024

Accurate and compliant group therapy billing requires a comprehensive understanding of patient eligibility, group composition, session structure, provider qualifications, and meticulous documentation. Session Structure: The duration, frequency, and content of group sessions impact billing and documentation requirements.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Medical Billing Regulatory Compliance 59

Medisys Compliance

JUNE 26, 2024

Introduction In mental health care, accurate documentation and coding are pivotal for effective treatment planning, patient care, and reimbursement. Detailed Documentation Thorough documentation of the patient’s symptoms, history, and diagnosis is crucial. Bipolar Disorder: F31.0 – F31.9; Schizophrenia: F20.0 – F20.9

Medical Billing 45

Medical Billing Medical Billing Outsourcing Medicaid Medicaid 45

Medisys Compliance

JULY 23, 2024

CPT Code 77427: This code for radiation treatment management has been revised to better delineate between simple and complex treatment plans, ensuring appropriate billing for the level of service provided. Compliance and Documentation Tips Accurate documentation is crucial for compliance and reimbursement in radiation oncology billing.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Compliance Informed Consent Medical Billing 59